The digital rectal prostate exam (or DRE) is a staple of gross-out comedies and edgy animated TV shows. The faces we make when we think about it tell the story: It’s not fun. And thinking about what a prostate exam could tell you? That sounds like even less fun.
You could find out you have prostate cancer. What then? Who wants to think about that?
As unpleasant as it all sounds, consider this: The five-year survival rate for men with distant stage prostate cancer (which has spread to distant organs) is just 29%. But that five-year rate improves to nearly 100% for men whose prostate cancer is found in its early, regional stage (confined to the prostate or nearby). Men like Ben Stiller, Colin Powell, Robert De Niro, and Arnold Palmer learned of their prostate cancer early enough to do something about it. And they survived to share their stories. The hope is that more men will learn from their experiences.
Here’s more good news: The dreaded DRE is not performed as often as it used to be. These days, your screening will likely involve a simple PSA (Prostate Specific Antigen) blood test. Blood is drawn from the arm and is tested to find the amount of PSA protein in the blood sample. From this, your doctor can decide whether more tests are needed, as well as when the PSA test should be performed again.
The American Cancer Society recommends a discussion about prostate screening for men at different levels of risk:
- At age 50 for those at average risk, and who are expected to live at least 10 more years.
- At age 45 for those at high risk, including African-American men and men with a first-degree relative (father, brother, or son) diagnosed at an early age (younger than 65).
- At age 40 for those at even higher risk (defined by having more than one first-degree relative diagnosed before age 65).
A DRE may be called for in some of these situations. But not necessarily.
Let’s say that, like Stiller, you do get a diagnosis at an early stage. As unpleasant as regional stage prostate cancer may sound, the treatments aren’t as bad as you might fear. The most common treatments are watch-and-wait, surgery, and radiation. Others include cryotherapy (freezing), high-intensity ultrasound, vaccine, or chemotherapy.
While certain treatment processes may adversely affect sexual function, sex can also improve after treatment. And in case you were wondering, the “frank and beans” (to borrow a phrase from Stiller’s 1998 movie There’s Something About Mary) are generally not involved.
To find out whether you should get a PSA screening, and to discuss your risk factors, talk to your doctor.